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Published Online: 24 August 2018

An fMRI Pilot Study of Cognitive Flexibility in Trichotillomania

Publication: The Journal of Neuropsychiatry and Clinical Neurosciences

Abstract

Trichotillomania is a relatively common psychiatric condition, although its neurobiological basis is unknown. Abnormalities of flexible responding have been implicated in the pathophysiology of obsessive-compulsive disorder and thus may be relevant in trichotillomania. The purpose of this study was to probe reversal learning and attentional set-shifting in trichotillomania. Twelve adults with trichotillomania and 13 matched healthy control subjects undertook a functional MRI task of cognitive flexibility. Group-level activation maps for extradimensional and reversal switches were independently parcellated into discrete regions of interest using a custom watershed algorithm. Activation magnitudes were extracted from each region of interest and study subject and compared at the group level. Reversal events evoked the expected patterns of insula and parietal regions and activity in the frontal dorsal cortex extending anterior to the frontal poles, whereas extradimensional shifts evoked the expected frontal dorsolateral and parietal pattern of activity. Trichotillomania was associated with significantly increased right middle frontal and reduced right occipital cortex activation during reversal and set-shifting. Elevated frontal activation coupled with reduced activation in more posterior brain regions was identified. These pilot data suggest potentially important neural dysfunction associated with trichotillomania.

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Information & Authors

Information

Published In

Go to The Journal of Neuropsychiatry and Clinical Neurosciences
Go to The Journal of Neuropsychiatry and Clinical Neurosciences
The Journal of Neuropsychiatry and Clinical Neurosciences
Pages: 318 - 324
PubMed: 30141727

History

Received: 1 March 2018
Revision received: 28 April 2018
Revision received: 11 May 2018
Accepted: 12 May 2018
Published online: 24 August 2018
Published in print: Fall 2018

Keywords

  1. Imaging
  2. Flexibility
  3. Cognition
  4. Trichotillomania

Authors

Details

Jon E. Grant, M.D., M.P.H. [email protected]
From the Department of Psychiatry and Behavioral Neuroscience, University of Chicago (JEG); the Department of Medicine, Computational, Cognitive, and Clinical Neuroimaging Lab, Imperial College, London (RD, AH); the Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom (SRC); and Cambridge and Peterborough NHS Foundation Trust, London (SRC).
Richard Daws, M.Sc.
From the Department of Psychiatry and Behavioral Neuroscience, University of Chicago (JEG); the Department of Medicine, Computational, Cognitive, and Clinical Neuroimaging Lab, Imperial College, London (RD, AH); the Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom (SRC); and Cambridge and Peterborough NHS Foundation Trust, London (SRC).
Adam Hampshire, Ph.D.
From the Department of Psychiatry and Behavioral Neuroscience, University of Chicago (JEG); the Department of Medicine, Computational, Cognitive, and Clinical Neuroimaging Lab, Imperial College, London (RD, AH); the Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom (SRC); and Cambridge and Peterborough NHS Foundation Trust, London (SRC).
Samuel R. Chamberlain, M.D., Ph.D.
From the Department of Psychiatry and Behavioral Neuroscience, University of Chicago (JEG); the Department of Medicine, Computational, Cognitive, and Clinical Neuroimaging Lab, Imperial College, London (RD, AH); the Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom (SRC); and Cambridge and Peterborough NHS Foundation Trust, London (SRC).

Notes

Send correspondence to Dr. Grant; e-mail: [email protected]

Funding Information

Wellcome Trust10.13039/100004440: 110049/Z/15/Z
Supported by a Wellcome Trust Clinical Fellowship to Dr. Chamberlain (reference 110049/Z/15/Z) and a grant from the Trichotillomania Learning Center to Dr. Grant.Dr. Grant is chair of the Scientific Advisory Board of the TLC Foundation for Body-Focused Repetitive Behaviors and currently receives funding from its BFRB Precision Medicine Initiative; he has received research grants from the American Foundation for Suicide Prevention, the National Center for Responsible Gaming, the National Institute on Alcohol Abuse and Alcoholism, and Takeda Pharmaceuticals; he receives yearly compensation from Springer Publishing for acting as Editor-in-Chief of the Journal of Gambling Studies; and he has received royalties from American Psychiatric Publishing, McGraw Hill, Norton Press, and Oxford University Press. Dr. Chamberlain consults for Cambridge Cognition and Shire. All other authors report no financial relationships with commercial interests.

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